Tag: Type II Diabetes

The glycemic index measures how much a fixed quantity of different foods raises your blood-sugar levels compared with a standard, pure glucose (GI=100). Foods with a high GI value (greater than 70) tend to cause a higher spike in blood sugar—and in insulin, the hormone that helps glucose get into cells. The spikes are especially problematic for people with diabetes, who lack an effective insulin system to clear the sugar from their blood. And, because high-GI foods are so quickly metabolized, they tend to make you hungry again sooner, says David Ludwig, M.D., Ph.D., a Harvard endocrinologist and author of Ending the Food Fight (Houghton Mifflin, 2007). Ludwig’s research found that obese teenage boys were hungrier after they’d eaten a high-GI breakfast of instant oatmeal, and ate 600 to 700 calories more at lunchtime than when they’d breakfasted on moderate- or low-GI meals like steel-cut oats or omelets.

By contrast, lower-GI foods (under 55) are metabolized more slowly, and are believed to keep your appetite on a more even keel. Some experts think that by tempering blood-sugar surges, eating low-GI foods may even help prevent the damage to cells that’s caused by high blood-glucose concentrations.

Following the glycemic index (GI) system can be confusing—“but only if you spend too much time crunching numbers and not looking at the big picture,” says Joyce Hendley, EatingWell’s nutrition editor and author of The EatingWell Diabetes Cookbook (The Countryman Press). Knowing a few overall principles can make low-glycemic eating much simpler, she explains:

1. Bigger is better.

Large food particles take longer for the body to break down and absorb, so they move more slowly through your digestive system. So in general, the more intact and less processed a food is, the lower its GI. Think whole rather than refined grains, whole fruit rather than fruit juice, steel-cut oats rather than instant oatmeal and stone-ground rather than plain cornmeal. When buying whole-grain bread choose stone-ground, sprouted or cracked-wheat types; the grain kernels should be visible.

2. Fiber up.

By definition, fiber is the part of plant foods that cannot be digested by the body, so fiber-rich foods like beans, nuts, dried fruits and high-fiber cereals, pasta and breads are inherently low on the GI. Focus on boosting fiber by eating more foods like these and you won’t have to think about GI.

3. Pair with protein.

When it has protein to break down, the stomach empties more slowly. Adding a little protein to a carbohydrate-based meal or snack—say, adding a few chicken strips and a sprinkle of cheese to your pasta bowl, or a light smear of peanut butter on your toast—can lower the GI value of your meal.

4. Drizzle on a healthy fat.

Like protein, fat molecules also slow down digestion, so including a little fat can lower a food’s GI and make it more satisfying. Be sure to choose heart-healthy unsaturated fats like vegetable oils and nuts. And, if you’re watching calories, be moderate: drizzle bread with a little olive oil, toss carrots with a bit of tasty dressing, sprinkle slivered almonds on your salad.

Following low-GI eating principles can help people with diabetes fine-tune their blood-sugar responses and may even help people with prediabetes lower their risk of progressing to full-blown disease. New research connects low-GI diets with lower risk of age-related macular degeneration, a major cause of blindness, and other work suggests a possible link with reducing risk for heart disease and even colorectal cancer.

And of course, there’s the tantalizing possibility that by its moderating effects on blood sugar and thus appetite, eating a low-GI diet may help people lose weight. Unfortunately, research results in this area have been mixed. Ludwig has found that low-GI diets seem to be most effective in people whose bodies secrete more insulin: more often “apple-shaped” people, who accumulate extra fat around their waists, compared to people with lower-body fat (“pear shapes”). “Apple-shaped people who have done poorly on traditional low-fat diets may do especially well on a low-glycemic-load diet,” he says. And, regardless of body shape, those who followed low-glycemic diets improved their triglyceride and HDL cholesterol levels, he added; both are important risk factors for heart disease.

Exercise should be on your daily to-do list, especially if you have Type II Diabetes. Let’s get started with these go-to tips:

1. Make a list of fun activities. You have lots of options, and you don’t have to go to a gym. What sounds good? Think about something you’ve always wanted to try or something you enjoyed in the past. Sports, dancing, yoga, walking, and swimming are a few ideas. Anything that raises your heart rate counts.

2. Get your doctor’s OK. Let them know what you want to do. They can make sure you’re ready for it. They’ll also check to see if you need to change your meals, insulin, or diabetes medicines. Your doctor can also let you know if the time of day you exercise matters.

3. Check your blood sugar. Ask your doctor if you should check it before exercise. If you plan to work out for more than an hour, check your blood sugar levels regularly during your workout, so you’ll know if you need a snack. Check your blood sugar after every workout, so that you can adjust if needed.

5. Ease into it. If you’re not active now, start with 10 minutes of exercise at a time. Gradually work up to 30 minutes a day.

6. Strength train at least twice a week. It can improve blood sugar control. You can lift weights or work with resistance bands. Or you can do moves like push-ups, lunges, and squats, which use your own body weight.

7. Make it a habit. Exercise, eat, and take your medicines at the same time each day to prevent low blood sugar, also called hypoglycemia.

8. Go public. Work out with someone who knows you have diabetes and knows what to do if your blood sugar gets too low. It’s more fun, too. Also wear a medical identification tag, or carry a card that says you have diabetes, just in case.

9. Be good to your feet. Wear athletic shoes that are in good shape and are the right type for your activity. For instance, don’t jog in tennis shoes, because your foot needs a different type of support when you run. Check and clean your feet daily. Let your doctor know if you notice any new foot problems.

When you exercise, your body needs extra energy from blood sugar, also called glucose. When you do something quickly, like a sprint to catch the bus, your muscles and liver release glucose for fuel. The big payoff comes when you do moderate exercise for a longer time, like a hike. Your muscles take up much more glucose when you do that. This helps lower your blood sugar levels. If you’re doing intense exercise, your blood sugar levels may rise, temporarily, after you stop.

The American Diabetes Association announced that diabetes accounts for more than 178,000 deaths annually. Its many complications, such as amputation, kidney failure and/or blindness, have a devastating impact on quality of life. Currently more than 24 million children and adults in the US have diabetes, and an estimated additional 5.5 million have undiagnosed diabetes. The worst part is that the numbers are rising! It is proposed that soon diabetes will exceed both heart disease and cancer as the leading cause of death.

Diabetes is characterized by a disturbance in the body’s glucose (sugar) metabolism. Insulin is a hormone needed to allow glucose to enter cells in order for them to produce energy. In Type I diabetes, the body produces little or no insulin. In Type II diabetes the body overproduces insulin. Chronically elevated levels of insulin raise the risk of degenerative diseases (cancer, heart disease, Alzheimer’s, etc.). To maintain quality of life and prevent many of the potential devastating complications, it is crucial for patients to monitor and maintain balanced levels of blood sugar.

When it comes to diabetes management, blood sugar control is often the central theme and the common mistake is to solely rely on medication. In some cases overuse of certain medications appear to control blood sugar, but in fact they can actually speed up the progression of the disease. Another reason why sole reliance on medication is a mistake is because diet and lifestyle play a major role in the cause, management and rate of progression of this disease. This fact cannot be emphasized enough! A therapeutic lifestyle, one that includes a personalized food plan as well as an exercise program, should always be the first line of therapy. In many cases with the right lifestyle program, the use of medication can either be reduced or totally eliminated!

FMCSA Proposes Revision to Diabetes Standards for Interstate Commercial Drivers. The Federal Motor Carrier Safety Administration (FMCSA) today announced a proposal to permit individuals with stable, well-controlled insulin-treated diabetes mellitus (ITDM) to be qualified to operate trucks and buses in interstate commerce. Under the Notice of Proposed Rulemaking, a driver’s treating clinician would be required to provide documentation annually to a health professional listed on the National Registry of Certified Medical Examiners who is performing the USDOT medical qualification examination affirming that the driver’s ITDM is stable and well-controlled. The increased medical review will strengthen both the health monitoring of the driver and the safety of the motoring public by ensuring that physically qualified individuals are operating commercial trucks and buses on the nation’s highways and roads. A copy of the Notice of Proposed Rulemaking is available at https://www.federalregister.gov/articles/2015/05/04/2015-09993/qualifications-of-drivers-diabetes-standard. Comments and evidentiary materials may be submitted to the docket through July 6, 2015. Contact: Kurt Larson: (202) 366-9999

The Journal of American Medicine (JAMA) published in August 2013 the first ever report comparing the State of Health in the US to that of 34 countries on measures of diseases, injuries and risk factors associated with pre-matured mortality, years lived with disability, and disability adjusted life years.

Although it was not surprising to find in this report that chronic disease epidemics continue to spread across the world, but that US is doing much worse than many other countries with similar economic strength. This can be attributed to an aging population, however, a significant amount of data supports key findings of unhealthy lifestyles, diet and environment exposures that constitute the American way of life today are major influencers.

Among many interesting facts presented in this report are these:

• The diseases and injuries with the largest number of premature mortality in 2010 were ischemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease, and road injury.(ALL of these are largely preventable diseases)

• The diseases with the largest number of years lived with disability in 2010 were low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders.(SOME of these are preventable conditions)

• The leading risk factors relating to disability adjusted life years were dietary risks, tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose (Type II Diabetes), physical inactivity, and alcohol use.(MOST of these are preventable risks)

So how can we use this information?

By changing our one-size-fits all method of health care to a more patient specific.

“How much better could we do if each patient received a comprehensive individualized functional medicine work-up and therapeutic intervention instead of a prescription? Performing an in-depth examination of the patient’s underlying dysfunctions, identifying the antecedents, triggers, and mediators of disease (including the contributions of environmental and lifestyle risks), and working to eliminate obstacles to healing within the context of a highly effective therapeutic partnership between patient and clinician is what functional medicine practitioners are known for—and that approach may well be the key to reversing and preventing not only diabetes but many other elements of the chronic disease epidemic as well.” —Institute of Functional Medicine

Because of its focus on acute care, our current medical model often fails at confronting both the causes of and solutions for the chronic disease epidemic, and must be replaced with a model of comprehensive care and prevention that is systems-based, integrative, patient-centered, and much more effective.